Cardiothoracic Surgery Flashcards
An infant is seen in your clinic due to respiratory difficulty. His mother says he will make a “crowing” sound with breathing and extend himself to breathe better. Upon investigating further, she admits he doesn’t eat too much. The diagnosis and treatment are?
Vascular rings
Surgery to divide the smaller of the two aortic arches
A 1-year old with frequent colds is brought in by his mother. On exam he has a systolic murmur and fixed split S2. The patient likely has? Treatment?
ASD
Catherization
A 2 month infant with a pansystolic murmur, pulmonary hypertension. and failure to thrive will have this on ECHO?
VSD
List the common findings on a child with tetralogy of fallot.
- episodes of cyanosis relieved by squatting
- small size with distal clubbing
- systolic ejection murmur
- RVH and small heart
A systolic murmur and exertional syncope is characteristic of?
Aortic stenosis
Valve replacement for aortic stenosis is needed if?
- gradient >50 mm Hg
- CHF
- wide pulse pressures
- diastolic murmur worsened by full expiration
Aortic insufficiency
Prosthetic valve’s will indicate?
The need for antibiotic prophylaxis
What are the characteristics of a patient with mitral stenosis?
- dyspnea in exertion
- cough and hemoptysis
- rumbling diastolic murmur
Mitral regurgitation is most likely to be heard?
Holosystolic that radiates to axilla and back
What is the indication for revascularization of coronary vessels?
> 70% stenosis with good distal flow
How would you treat single vessel coronary disease versus multi-vessel coronary disease?
Single vessel: angioplasty and stent
Multi-vessel: coronary bypass
What does the pulmonary wedge pressure tell you in a patient with low cardiac output?
Low (<3): IV fluids needed
High (>20): ventricular failure
What are exam characteristics of constrictive pericarditis?
- dyspnea on exertion
- hepatomegaly
- ascites
- square root sign (filling pressure)
- Cath showing equalization of pressures
What is the best initial workup for lung cancer?
- comparing chest xray’s
- CT and sputum cytology
How is lung cancer diagnosed?
Bronchoscopy with biopsy for central lesions and percutaneous biopsy for peripheral lesions.
Small cell lung cancer is treated with?
Chemo and radiation
What residual lung function is required after surgery for a lung cancer to be considered operable?
FEV1 of 800 mL
Patients with massive hemoptysis will lose how much blood? Death in this case is generally due to?
> 600 cc
Asphyxiation
How do you differentiate between a lung module and lung mass?
A nodule <3 cm, a mass is >/= 3 cm
The majority of lung cancers are?
Non-small cell
Evaluation of the cause of a pleural effusion is done via?
Light’s Criteria
Diagnosis of a chylothorax is made by?
Thoracentesis showing TG’s >110 mg/dL or chylomicron presence
Patients with a tension pneumothorax should have this done before a chest tube is placed?
Needle decompression
